Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Clin Infect Dis. 2022 Mar 9;74(5):924-932. doi: 10.1093/cid/ciab155.
Even well into the 21st century, infectious diseases still account for most causes of fever of unknown origin (FUO). Advances in molecular technologies, including broad-range polymerase chain reaction (PCR) of the 16S ribosomal RNA gene followed by Sanger sequencing, multiplex PCR assays, and more recently, next-generation sequencing applications, have transitioned from research methods to more commonplace in some clinical microbiology laboratories. They have the potential to supplant traditional microbial identification methods and antimicrobial susceptibility testing. Despite the remaining challenges with these technologies, publications in the past decade justify excitement about the potential to transform FUO investigations. We discuss available evidence using these molecular methods for FUO evaluations, including potential cost-benefits and future directions.
即使到了 21 世纪，传染病仍然是不明原因发热（FUO）的主要原因。分子技术的进步，包括 16S 核糖体 RNA 基因的广谱聚合酶链反应（PCR），随后是 Sanger 测序、多重 PCR 检测，以及最近的下一代测序应用，已经从研究方法转变为一些临床微生物学实验室中更为常见的方法。它们有可能取代传统的微生物鉴定方法和抗菌药物敏感性测试。尽管这些技术仍然存在挑战，但过去十年的出版物证明了它们在改变 FUO 研究方面的潜力令人兴奋。我们讨论了使用这些分子方法进行 FUO 评估的现有证据，包括潜在的成本效益和未来的方向。
